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INTRODUCTION: This study aimed to examine important points of focus, trends, and depth of research on non-pharmacological interventions for the management of labor pain worldwide from a macro perspective and present an extensive definition of research fields regarding non-pharmacological interventions. METHODS: Bibliometric methods were used in this study. With comprehensive keyword lists, the Web of Science and PubMed databases were searched using different screening strategies for publications made until 25 February 2023. RESULTS: Studies on non-pharmacological interventions in the management of labor pain have continued to develop since 2003 with great momentum. In this study, the most productive country in research on non-pharmacological interventions was found to be Iran, while Australia, the USA, China, and the United Kingdom were the most notable ones in terms of collaboration. The most prevalently studied non-pharmacological interventions were hydrotherapy and acupuncture. The results of the co-word analysis revealed 5 main themes about this field of research. CONCLUSION: The results of this study showed that interest in studies on non-pharmacological interventions in the management of labor pain has increased, the quality of research in the field is high, international collaboration is increasingly higher, and technological approaches have started to emerge in relevant studies.
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Terapia por Acupuntura , Dor do Parto , Feminino , Gravidez , Humanos , Dor do Parto/terapia , Austrália , Bibliometria , ChinaRESUMO
This study aims to explore trends and principal research areas in the literature on Cognitive Disengagement Syndrome (CDS) in children aged 0-17 from a macro perspective. A total of 236 studies, selected based on inclusion and exclusion criteria from the Web of Science and Scopus databases, formed the data source for this research. We conducted a bibliometric analysis to examine the growth of CDS literature and to identify the most productive countries, relevant journals and publications, and trending topics. Additionally, through content analysis, we identified general research themes, sample trends, and methodologies used in these studies. Our findings reveal that the relatively new field of CDS research is expanding. Our thematic analysis shows that the literature on CDS covers a broad spectrum of research topics, addressing various facets of the syndrome and identifying current research themes. The existing studies highlight the complex nature of CDS and its diverse cognitive, psychological, and neurological impacts. Our results also suggest that while research is more prevalent in certain age groups, there is a need to encompass a wider demographic range, considering CDS's potential impact across different life stages. This bibliometric analysis offers a comprehensive review of the current knowledge in the CDS field, providing a valuable resource for researchers. Our analyses and findings can guide future research in this area and suggest approaches for broader study frameworks. It is anticipated that ongoing and future research in the CDS field will incorporate these insights to more effectively address the syndrome's varied aspects and consequences.
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Bibliometria , Transtornos do Neurodesenvolvimento , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos do Neurodesenvolvimento/fisiopatologia , Transtornos do Neurodesenvolvimento/psicologiaRESUMO
INTRODUCTION: Hyponatremia is the most common electrolyte disorder often present in peritoneal dialysis (PD) patients. The aim of this retrospective study was to investigate the effect of hyponatremia on mortality in patients undergoing PD. METHODS: The health records of adult individuals with an inserted PD catheter identified via the centralized national e-health database were used. RESULTS: The mean age of the 846 patients included in the study was 52.48 years (±14.6). The mean sodium level was 136.51 mEq/L. Sodium levels <137 mEq/L were associated with higher death risk independent of comorbidities. There was a 0.821 times less reduction in mortality for each mEq /L increase in serum sodium. CONCLUSION: Our study provides evidence that monitoring and adjusting serum sodium levels is crucial in managing PD patients with hyponatremia, as low serum sodium level was found to be a significant and independent predictor of mortality.
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Hiponatremia , Diálise Peritoneal , Adulto , Humanos , Pessoa de Meia-Idade , Hiponatremia/epidemiologia , Hiponatremia/etiologia , Estudos Retrospectivos , Inflamação/complicações , SódioRESUMO
OBJECTIVE: The long- and short-term benefits of breastfeeding for mothers and infants are known, and the number of studies on this subject is increasing daily. This study aimed to reveal current research trends, hotspots, and future frontiers in research on breastfeeding in Turkey. MATERIALS AND METHODS: The most productive institutions, influential authors, the journals with the most publications by the authors, core research teams, and keywords in Turkey in the field of breastfeeding were analyzed using bibliometric methods. Additionally, breastfeeding-related articles published in the Web of Science Core Collection between 1980 and 2022 were scanned. The collected data were analyzed with the R Bibliometrix package program and VOSviewer. RESULTS: It was determined that research on breastfeeding has accelerated since 2004, and the number of citations has increased with the number of publications. The fields of most produc- tive writers in the area were found as social pediatrics, and the most influential institutions were Istanbul University and Hacettepe University. It was determined that there was no specializa- tion in research on breastfeeding among authors distributed based on their productivity. The results also revealed the most influential articles and journals. The word analysis revealed that the breastfeeding literature in Turkey is sensitive to current developments, whereas the current status of breastfeeding, the factors affecting breastfeeding, and the effects of breastfeeding are the top areas of research. It was observed that maternal attachment and coronavirus dis- ease-2019 (COVID-19) pandemic-related issues have been studied more in recent years. CONCLUSION: This bibliometric analysis contributes to understanding the current status and development of breastfeeding research in Turkey.
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BACKGROUND: Breastfeeding has been the subject of scientific studies for many years. Identifying the current trends and hotspots in breastfeeding research can further advance understanding in the field. RESEARCH AIM: This study aimed to review the basic and conceptual structure of the literature on breastfeeding from a macro perspective. METHODS: The dataset for this study included 8,509 articles published between 1980 and 2022 accessed through the Web of Science database. Bibliometric methods were used to assess the growth direction of the literature on breastfeeding, the publication performance by country, influential journals and articles, co-citation networks, and keywords. RESULTS: Research on breastfeeding developed slowly until the 2000s, at which point the speed of growth increased. The United States was the country in which most of the breastfeeding research was produced as well as being at the center of international collaborative networks. An examination of author productivity established that there was no specialization in breastfeeding. The results of citation and keyword analyses demonstrated that the literature on breastfeeding is sensitive to current developments, and the psychological aspects of breastfeeding have been intensively discussed, especially in recent years. Moreover, our results demonstrate that breastfeeding support programs are a distinct area if interest. Despite the abundance of research available, more studies are needed for specialization in this field. CONCLUSION: This broad overview of the field of breastfeeding research can inform the direction and advancement of the literature.
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Aleitamento Materno , Pesquisa em Enfermagem , Feminino , Humanos , Bibliometria , Estados UnidosRESUMO
Background: Inaccurate test results may be a reason why vitamin D deficiency is seen as a common problem worldwide. Interferences from the sample matrix during testing are the most important factors in measurement errors. In this study, the relationship between triglycerides and total cholesterol levels and vitamin D levels in Turkey was investigated. Methods: The 25-hydroxyvitamin D test results and lipid test results studied in Turkey in 2021 were compared. Data were obtained from the Ministry of Health National Health Database. Simultaneously, 25-hydroxyvitamin D, triglyceride, and total cholesterol levels were studied, and 1,135,644 test results were taken as the basis. Results: In the group of patients with total cholesterol levels between 0-10.33 mmol/L, the proportion of patients below 20 mg/L ranged from 56.8% to 61.8%. In the patient group with cholesterol between 10.36-259 mmol/L, the rate of patients with less than 20 mg/L was between 70.8-100%, while the rate of patients with cholesterol above 100 mg/L was 0%. The mean 25-hydroxyvitamin D level was 20.1 mg/L in the patient group with a total cholesterol level between 0-10.33 mmol/L, and 16 mg/L in the patient group with a cholesterol level above 10.36 mmol/L. The mean 25-hydroxyvitamin D level was 20.11 mg/L in the patient group with triglycerides 0-10.16 mmol/L, and the 25-hydroxyvitamin D level was 12.28 mg/L in the patient group with triglycerides 10.17-113 mmol/L. The proportion of patients with vitamin D levels above 100 mg/L was found to be 0% in the group of patients with triglycerides above 10.17-113 mmol/L. Conclusions: According to this study, there is a risk of toxicity when administering vitamin D therapy in patients with high cholesterol and triglycerides levels. This study is the first of this size in the literature. High triglycerides and cholesterol levels can cause inaccurate measurement of vitamin D levels, so care should be taken when evaluating these tests.
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INTRODUCTION: The effect of vitamin D status on steatosis has not been fully elucidated. In this study, we planned to investigate this interaction using a large-scale population-based cohort. MATERIAL AND METHODS: Patients diagnosed with simple steatosis (K76.0) and non-alcoholic steatohepatitis (NASH) (K75.8) by using the International Classification of Diseases 10th Revision (ICD-10) coding system, and who had 25-hydroxyvitamin D (25OHD) measurements at the diagnosis, were included in the study. Control group comprised subjects without liver diseases. Age, gender, alanine aminotransferase (ALT) and 25OHD levels, and the date of the measurements were recorded. RESULTS: We compared ALT and 25OHD measurements between the patient and control groups, and between the simple steatosis and NASH subgroups. 25OHD levels were lower and ALT levels were higher in the patient group (p < 0.001, effect size = 0.028, and p < 0.001, effect size = 0.442, respectively). Logistic regression analysis showed that when 25OHD levels decrease by 1 ng/dL, it increases the risk of being in the patient group by 3.7%. CONCLUSION: Our results suggest that vitamin D status may be related to the development of non-alcoholic fatty liver disease (NAFLD). Although this relationship is weak, it may be important in the pathogenesis of steatosis.
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Hepatopatia Gordurosa não Alcoólica , Deficiência de Vitamina D , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Vitamina D , Deficiência de Vitamina D/complicações , FígadoRESUMO
BACKGROUND: Adequate antithrombotic therapy is essential to prevent thrombus formation during percutaneous endovascular interventions (PVI). We hypothesize that interventions for non-complex lesions of iliac arteries do not need procedural anticoagulation if patients are under dual antiplatelet therapy (DAPT). METHODS: Iliac PVIs performed without procedural anticoagulation were retrospectively screened between 2017 and 2021. Baseline characteristics of patients, in-hospital events and 30-day follow-ups were obtained from hospital records. Each PVI was reviewed for procedural details. Primary safety outcome was thromboembolic events during intervention. Secondary safety outcome was adverse vascular events at 30-day follow-up. Procedure times of iliac interventions were compared to peripheral angiography procedures of patients with similar demographic characteristics. RESULTS: We identified 108 iliac interventions without procedural anticoagulation, median age of 62 (interquartile range 56-68) years, 9 (8.3%) females. Median lesion length was 30 (19-50) mm. We observed a thrombotic finding in 4 (3.7%) procedures. Visible luminal thrombus was observed in 2 (1.9%) and introducer sheath thrombosis in 2 procedures (1.9%), all of which were in patients with in-stent lesions. No distal embolization was observed in final angiography of these procedures. At 30-day follow-up, acute limb ischemia was not observed and clinically driven target vessel revascularization was not required in any of the patients. Procedure time of iliac interventions was similar to that of lower extremity diagnostic procedures [18 (11-24) vs 18 (14-24) min, respectively, P = .364]. No major bleeding event was observed after iliac interventions. CONCLUSION: Non-complex lesions of iliac arteries can be managed within a time frame similar to that of lower extremity diagnostic procedures. These interventions can be performed safely without procedural anticoagulation, provided patient receives DAPT. Intervention of in-stent lesions should ideally be avoided without procedural anticoagulation.
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Procedimentos Endovasculares , Doenças Vasculares Periféricas , Trombose , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Masculino , Resultado do Tratamento , Estudos Retrospectivos , Doenças Vasculares Periféricas/terapia , Anticoagulantes/efeitos adversos , Trombose/etiologia , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/métodos , Fatores de Risco , Artéria Ilíaca/diagnóstico por imagemRESUMO
To which extent the pre-existing hypothyroidism or hyperthyroidism has an impact on coronavirus infection 2019 (COVID-19) outcomes remains unclear. The objective of this study was to evaluate COVID-19 morbidity and mortality in patients with pre-existing thyroid dysfunction. A retrospective cohort of patients with a polymerase chain reaction (PCR)-conï¬rmed COVID-19 infection (n=14 966) from March 11 to May 30, 2020, was established using the database of the Turkish Ministry of Health. We compared the morbidity and mortality rates of COVID-19 patients with pre-existing hypothyroidism (n=8813) and hyperthyroidism (n=1822) to those patients with normal thyroid function (n=4331). Univariate and multivariate regression analyses were performed to identify the factors associated with mortality. Mortality rates were higher in patients with hyperthyroidism (7.7%) and hypothyroidism (4.4%) than those with normal thyroid function (3.4%) (p<0.001 and p=0.008, respectively). Pre-existing hyperthyroidism was significantly associated with an increased risk of mortality (OR 1.54; 95% CI, 1.02-2.33; p=0.042) along with advanced age, male gender, lymphopenia and chronic kidney disease (p<0.001 for all). Although a potential trend was noted, the association between pre-existing hypothyroidism and mortality was not significant (OR 1.36; 95% CI, 0.99-1.86; p=0.055). In conclusion, this study showed an association between pre-existing hyperthyroidism with higher COVID-19 mortality. A potential trend towards increased mortality was also observed for hypothyroidism. The risk was more pronounced in patients with hyperthyroidism.
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COVID-19 , Hipertireoidismo , Hipotireoidismo , Doenças da Glândula Tireoide , Humanos , Masculino , Estudos Retrospectivos , COVID-19/complicações , Hipotireoidismo/complicações , Hipotireoidismo/epidemiologia , Hipertireoidismo/complicações , Hipertireoidismo/epidemiologiaRESUMO
Background: Across the world, 25-hydroxyvitamin D (25-OHD) deficiency is a major health problem associated with many chronic diseases in the geriatric population. Prior to this study, there were no data regarding 25-OHD levels among individuals over the age of 65 in Turkey. The aim of this study was to assess 25-OHD levels and seasonal variations in these values among people over the age of 65 in Turkey. Methods: This study included vitamin D measurements taken in 2016, 2017, and 2018 from the Turkish population over the age of 65. The age, gender, and seasonal average data of the study population were defined. The study data were obtained from the database of the Ministry of Health, and a Kolmogorov-Smirnov test was used to assess the distribution of the data. Medians and interquartile ranges (IQRs) were calculated for all categories, as the data were nonparametric. Results: The number of vitamin D measurements taken from the geriatric individuals included in this study was 305,329 for 2016, 576,452 for 2017, and 752,837 for 2018. The medians and IQRs of the 25-OHD levels in this population were 16 µg/L (IQR 7.45-24.55 µg/L) for 2016, 16.1 µg/L (IQR 7.8-24.4 µg/L) for 2017, and 16.4 µg/L (IQR 8.95-23.85 µg/L) for 2018. Conclusions: While the 25-OHD levels of older men tended to increase during the period of seasonal sunlight in Turkey, this variability was observed in elderly women. This suggests that older women tend to live more sedentary lives and have insufficient sun exposure. Overall, the median 25-OHD levels of individuals over the age of 65 tended to decrease each year.
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Ectopic maxillary third molar teeth can often be located in the maxillary sinus, and the region necessarily requires a multidisciplinary approach due to its proximity to the oral cavity. Ectopic third molar tooth in the maxillary sinus was detected by oral and radiological examination in a 26-year-old male patient. The tooth was removed, and sinus augmentation was performed through the Caldwell-Luc procedure, and a dental implant was placed afterward. The treatment was ended by making a prosthetic metal-supported ceramic crown. Both removals of the ectopic tooth from the maxillary sinus, sinus augmentation, and implant operation can be achieved in a single operation of a single-window opened in the bone. As a result, because of the adjacency of the regions in operations related to the maxillary sinus, both the dental practitioner and the otolaryngologist should evaluate the operation, and multidisciplinary work should be done when necessary.
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Implantes Dentários , Dente Supranumerário , Adulto , Odontólogos , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Papel ProfissionalRESUMO
AIM: The effect of hypertension (HT) and antihypertensive therapies such as renin-angiotensin-aldosterone system (RAAS) blockers on the disease course in COVID-19 patients is controversial. The purpose of this study was to evaluate the effect of HT and antihypertensive therapies on the course of COVID-19 disease. METHOD: The age, sex, comorbid diseases, and antihypertensive therapies of 132,790 patients with positive COVID-19 real-time transcriptase polymerase chain reaction (RT-PCR) tests in the Turkish Health Ministry National COVID-19 database between 11 March and 31 May 2020, were examined and analyzed. RESULTS: Forty-one percent of the 132,790 patients in this study (median age: 40, 47.3% female) were hospitalized for treatment, and 4.5% were followed-up in the intensive care unit (ICU). The most frequent comorbid disease, at 19.5%, was HT (n = 25,863). Mortality was determined in 4.9% of HT patients and 1.9% of non-HT patients (p < .001). HT, age, and male gender emerged as independent predictors of hospitalization and admission to the ICU, while HT was not a predictor of mortality. In addition, no adverse effect of any antihypertensive treatment, including RAAS inhibitors, on mortality was detected. CONCLUSION: Based on Turkish national data, HT is common in COVID-19 patients, but does not appear to be an independent predictor of mortality, and no adverse effect of RAAS inhibitors on COVID-19-related mortality was observed.
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Tratamento Farmacológico da COVID-19 , COVID-19 , Hipertensão , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Anti-Hipertensivos/farmacologia , COVID-19/epidemiologia , Feminino , Humanos , Hipertensão/induzido quimicamente , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Masculino , Sistema Renina-Angiotensina , Estudos RetrospectivosRESUMO
INTRODUCTION: COVID-19 disease has a worse prognosis in patients with diabetes, but comparative data about the course of COVID-19 in patients with type 1 (T1DM) and type 2 diabetes (T2DM) are lacking. The purpose of this study was to find out the relative clinical severity and mortality of COVID-19 patients with T1DM and T2DM. MATERIAL AND METHODS: A nationwide retrospective cohort of patients with conï¬rmed (PCR positive) COVID-19 infection (n = 149,671) was investigated. After exclusion of individuals with unspecified diabetes status, the adverse outcomes between patients with T1DM (n = 163), T2DM (n = 33,478) and those without diabetes (n = 115,108) were compared by using the propensity score matching method. The outcomes were hospitalization, the composite of intensive care unit (ICU) admission and/or mechanical ventilation, and mortality. RESULTS: The patients with T1DM had higher mortality than the age- and gender-matched patients with T2DM (n = 489) and those without diabetes (n = 489) (p < 0.001). After further adjustment for the HbA1c, and microvascular and macrovascular complications, the odds of mortality (OR: 3.35, 95% CI: 1.41-7.96, p = 0.006) and ICU admission and/or mechanical ventilation (OR: 2.95, 95% CI: 1.28-6.77, p = 0.011) were significantly higher in patients with T1DM compared to those with T2DM. Older age (OR: 1.06, 95% CI: 1.01-1.12, p = 0.028) and lymphopaenia (OR: 5.13, 95% CI: 1.04-25.5, p = 0.045) were independently associated with mortality in patients with T1DM. CONCLUSIONS: Patients with T1DM had worse prognosis of COVID-19 compared to T2DM patients or those without diabetes. These cases should be cared for diligently until more data become available about the causes of increased COVID-19 mortality in T1DM.
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COVID-19 , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Hospitalização , Humanos , Estudos RetrospectivosRESUMO
BACKGROUND: It is well documented that patients with chronic metabolic diseases, such as diabetes and obesity, are adversely affected by the COVID-19 pandemic. However, when the subject is rare metabolic diseases, there are not enough data in the literature. AIM: To investigate the course of COVID-19 among patients with Gaucher disease (GD), the most common lysosomal storage disease. METHODS: Based on the National Health System data, a retrospective cohort of patients with confirmed (polymerase chain reactionpositive) COVID-19 infection (n = 149 618) was investigated. The adverse outcomes between patients with GD (n = 39) and those without GD (n = 149 579) were compared with crude and propensity score-matched (PSM) groups. The outcomes were hospitalisation, the composite of intensive care unit (ICU) admission and/or mechanical ventilation and mortality. RESULTS: The patients with GD were significantly older and had a higher frequency of hypertension (HT), Type 2 diabetes mellitus (T2DM), dyslipidaemia, asthma or chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease, heart failure and cancer. Although hospitalisation rates in Gaucher patients were found to be higher in crude analyses, the PSM models (model 1, age and gender matched; model 2, matched for age, gender, HT, T2DM and cancer) revealed no difference for the outcomes between patients with GD and the general population. According to multivariate regression analyses, having a diagnosis of GD was not a significant predictor for hospitalisation (P = 0.241), ICU admission/mechanical ventilation (P = 0.403) or mortality (P = 0.231). CONCLUSION: According to our national data, SARS-CoV-2 infection in patients with GD does not have a more severe course than the normal population.
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COVID-19 , Diabetes Mellitus Tipo 2 , Doença de Gaucher , COVID-19/epidemiologia , Estudos de Coortes , Diabetes Mellitus Tipo 2/epidemiologia , Doença de Gaucher/complicações , Doença de Gaucher/epidemiologia , Hospitalização , Humanos , Unidades de Terapia Intensiva , Pandemias , Estudos Retrospectivos , SARS-CoV-2RESUMO
PURPOSE: While obesity is related to more severe outcomes of coronavirus disease 2019 (COVID-19), factors leading to poor prognosis still remain unclear. The present study evaluated the outcomes of COVID-19 patients who were overweight or obese and variables associated with severe disease in a large group of consecutive cases. METHODS: A nationwide retrospective cohort study was performed using the Turkish National Healthcare Database. Demographic characteristics, laboratory tests, comorbidities, and medications of patients registered between March 11 and May 30, 2020, were recorded. RESULTS: A total of 14, 625 patients (median age:42, IQR:26 years; female 57.4%) with normal weight (34.7%), overweight (35.6%), and obesity (29.7%) were included. Hospitalization, ICU admission, intubation/mechanical ventilation, pulmonary involvement, and mortality were significantly higher in patients who were overweight or obese. In adjusted analyses, both overweight (OR, 95% CI: 1.82, 1.04-3.21; p=0.037) and obesity (OR, 95% CI: 2.69, 1.02-1.05; p<0.001) were associated with a higher intubation/mechanical ventilation rate but only obesity was associated with increased mortality (OR, 95% CI: 2.56, 1.40-4.67; p=0.002). Old age, male gender, chronic kidney disease, and high C reactive protein levels were independently associated with COVID-19 mortality in overweight or obese patients. CONCLUSIONS: COVID-19 patients who were overweight or obese were more likely to have adverse outcomes but only obesity was a predictor of mortality. Such patients should receive urgent medical attention and active management, especially the elderly, men, and people with chronic kidney disease.
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COVID-19/mortalidade , Obesidade/mortalidade , SARS-CoV-2 , Adolescente , Adulto , COVID-19/terapia , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/terapia , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Turquia/epidemiologiaRESUMO
Previous studies reported that COVID-19 patients with cancer had higher rates of severe events such as intensive care unit (ICU) admission, mechanical ventilation (MV) assistance, and death during the COVID-19 course compared to the general population. However, no randomized study compared the clinical course of COVID-19 in patients with hematologic cancers to patients with solid cancers. Thus, in this study, we intend to reveal the outcome of COVID-19 in hematologic cancer patients and compare their outcomes with COVID-19 patients with solid cancers. The data of 926 laboratory-confirmed COVID-19 patients, including 463 hematologic cancer patients and an age-gender paired cohort of 463 solid cancer patients, were investigated retrospectively. The frequencies of severe and critical disease, hospital and ICU admission, MV assistance were significantly higher in hematologic cancer patients compared with the solid cancer patients (p = 0.001, p = 0.045, p = 0.001, and p = 0.001, respectively). The hospital stay was longer in patients with hematologic cancers (p = 0.001); however, the median ICU stay was 6 days in both groups. The case fatality rate (CFR) was 14.9% in patients with hematologic cancers, and it was 4.8% in patients with solid cancers, and there was a statistically significant difference regarding CFR between groups (p = 0.001). Our study revealed that COVID-19 patients with hematologic cancers have a more aggressive course of COVID-19 and have higher CFR compared to COVID-19 patients with solid cancers and support the increased susceptibility of patients with hematologic cancers during the outbreak.
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COVID-19 , Neoplasias Hematológicas , Neoplasias , Neoplasias Hematológicas/complicações , Humanos , Unidades de Terapia Intensiva , Neoplasias/complicações , Respiração Artificial , Estudos Retrospectivos , SARS-CoV-2RESUMO
INTRODUCTION: To investigate the effect of preexisting treatment with dipeptidyl peptidase-4 inhibitors (DPP-4is) on COVID-19-related hospitalization and mortality in patients with type 2 diabetes mellitus (T2DM). METHODS: A multicenter, retrospective cohort study was conducted using patient data extracted from the Turkish National Electronic Database. All patients who tested positive for COVID-19 (PCR test) between 11 March through to 30 May 2020 were screened for eligibility (n = 149,671). Following exclusion of patients based on pre-determined inclusion criteria, patients with T2DM using a DPP-4i or glucose-lowering medications other than a DPP-4i were compared for mortality and hospitalization. The propensity score method was used to match age, gender, micro- and macrovascular complications, and medications in the two groups. Independent associates of mortality were analyzed using multivariable analysis on the whole T2DM population. RESULTS: A total of 33,478 patients with T2DM who tested postive for COVID-19 who met the inclusion criteria were included in the analysis. Median (interquartile range) age was 54 (22) years and 42.4% were male. Of these, 9100 patients using DPP-4is (n = 4550) or other glucose-lowering drugs (n = 4550) were matched in two groups. After matching, analysis revealed a lower mortality in the DPP-4i group (9.5 vs. 11.8%; p < 0.001). In the multivariable model, the use of DPP-4is (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.35-0.91; p = 0.02) was associated with lower mortality in the whole sample, while age, male gender, computed tomography finding of COVID-19, obesity, low glomerular filtration rate, and an insulin-based regimen also predicted increased risk of death. There was no association between the preexisting treatment with DPP-4is and COVID-19-related hospitalization in the matched analysis or multivariate model. The rate of admission to the intensive care unit and/or mechanical ventilation favored the DPP-4i group (21.7 vs. 25.2%; p = 0.001), although this association became saturated in the multivariate analysis (OR 0.65, 95% CI 0.39-1.08; p = 0.099). CONCLUSIONS: The results of this study demonstrate an association between DDP-4i use and reduced mortality in people with T2DM who tested PCR positive for COVID-19.
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OBJECTIVES: The aim of this study is to evaluate dentists' working conditions and the policies implemented for dentistry during the COVID-19 pandemic. In addition, effects of working in private practice or governmental practice in terms of pandemic are also evaluated in the manuscript. METHODS: A questionnaire was prepared to elicit dentists' working conditions during the pandemic and analyze and evaluate the policies implemented for dentistry. The questionnaires were sent to the dentists registered in the Turkish Dental Association (TDA) via e-mail, and collected between September 30, 2020, and October 20, 2020. Descriptive statistical methods, validity and reliability analysis, and regression analysis were applied for data analysis. RESULTS: Seven hundred thirty-four dentists registered in the Turkish Dental Association took part in the study. 47% of respondents examined five or fewer patients per day during the pandemic. Dentists working in private practice examine more patients per day during the pandemic. 80.8% of the respondents experienced anxiety while examining patients during the pandemic. While the dentist's anxiety level increased with increasing the number of patients examined per day (ß: 0.399), it decreased with increasing the dentist's age (ß: -0.065). Respondents were not satisfied with the pandemic's management, with the decisions taken regarding dentistry, and with the supports provided to the dentists. 85.8% of the respondents were concerned about their professional future, which is higher among dentists who work in governmental practice (p < 0.05, ANOVA). CONCLUSIONS: Increasing dentists' representation in the management of the pandemic and the future policy-making process, taking steps for the future by creating planning processes will eliminate the uncertainties and dissatisfaction and ensure to be ready for new pandemics.